A Guide to Dealing with Low Breast Milk Supply

My Personal Experience with Low Milk Supply

My postpartum journey was very difficult. It was an extremely emotional time for me. My feelings of pure bliss were exaggerated by intense fatigue and all the guilt and grief from not being able to exclusively breastfeed my baby. Now having an eight month old and being able to use my experience and perspective I am happy and proud of our breastfeeding journey and all the hard work and time I put into maintaining breastfeeding. I have learned a great deal about breast milk supply.

What Causes Low Breast Milk Supply?

There are many factors that can contribute to low milk supply; a premature baby, an ineffective latch, lip or tongue tie in the baby, prior nipple piercings or trauma, and breast augmentation can all impact supply. Additionally, medical conditions like Hormonal Disorders (PCOS, Thyroid Issues, Diabetes, Hypertension, Luteal Phase Defect), Hypoplasia/Insufficient Glandular Tissue, and flat or inverted nipples can all be contributing factors to breast milk supply.

I felt so upset about not having enough breast milk and in those first days really desired an understanding of why my body wasn’t able to make enough nourishment for my baby. It felt like the lactation consultants and doctors I saw truly didn’t care about explaining or figuring out why my breasts weren’t producing enough milk. I was able to do research to develop a better understanding of possible causes for low supply but was never diagnosed with a particular condition.

Tips for Increasing Low Milk Supply

There are many lactogenic foods that can help boost supply. Fortunately, most of the foods are easily accessible and relatively easy to add to your meals. I found many helpful recipes for lactation cookies and smoothies online that included multiple ingredients known to increase supply. At the local farmer’s market I found sprouted fenugreek and alfalfa. The sprouts were easy to add in a salad or snack on by the handful and helped maintain my supply.

Many herbs are known to help increase supply. Fenugreek is a popular supplement and is readily available in capsules. Dosage recommendations vary for fenugreek and I was instructed by a lactation consultant to take four capsules three times a day (beware! This herb upset my stomach). You should also note that consuming large quantities of Fenugreek creates a maple syrup like smell on your skin.

Other galactogogues include Blessed Thistle, Goats Rue, and Moringa. These herbs are a bit harder to find but are all are available on Amazon. I followed recommended dosages included on the products. Several brands of herbs like More Milk Plus and Mommy Knows Best are widely renowned for their effectiveness. I was able to see some results using the Mommy Knows Best supplements. I found several excellent tinctures and herb blends at Local herb shops. Mrs. Patels sells fenugreek bars, teas, and other treats to support milk supply. I splurged and tried the chocolate fenugreek bars and they made a slight difference in my extremely low supply. Many of the herbs and tinctures I have taken have a pretty harsh taste and a little chocolate helped get the medicine down.

What to Avoid

There are also things that I had to be intentional to avoid while breastfeeding with a low supply. Foods that negatively affect supply include peppermint, spearmint, parsley, sage, and oregano. Other things I was mindful of included getting as much rest as possible, keeping a close eye on my health, avoiding excessive amounts of caffeine, and being under too much stress all impacted my supply. I don’t smoke cigarettes or regularly drink alcohol but both are known to interfere with the let-down reflex. I also did not start taking my regular birth control pills because they contain estrogen, which is known to decline milk production. Medications like Antihistamines, decongestants, and diuretics all decrease breast milk supply as well.

There are prescription drugs that can induce lactation. Reglan and Domperidone are known to increase supply. Reglan is documented to have adverse side effectsof depression and involuntary body movements. The use of Domperidone is very controversial in the United States and is not currently approved by the FDA. The use is widespread and well documented in other areas. A great resource is the podcast Breastfeeding Outside of the Box and one of their episodes covers Domperidone.

Pumping Like a Pro

I hate pumping, and I don’t know anyone who enjoys it. In the early months I was pumping around the clock every two hours after putting baby to breast. Pumping was very grueling and uncomfortable. It was upsetting for me to pump because my baby was very fussy in those days and I often had to hold her while I pumped. A hands-free pumping bra was essential. I used the Simple Wishes Pumping Bra but wish I knew about the Dairy Fairy Pumping Bra. The Dairy Fairy bra can be used as a hands-free pumping bra and a regular bra so no need to change in and out throughout the day.

Slanted Flanges were a gift I received from a friend and did make a slight difference with my pumping output and comfort. I found out about nipple cushions a bit too late, but have heard rave reviews about how they do wonders for making pumping more tolerable and increase milk pumped. I rented a Medela Symphony hospital grade pump but would love to have tried Spectra Pumps because they are the most affordable hospital grade pumps around.

Before I pumped I always started with a warm compress. A creative Lactation Consultant recommended I use a disposable diaper and fill it with hot water to warm my breasts before I pump, this worked wonders and held more warmth than a washcloth. While pumping I always did breast compressions and saw a difference in my output. For one dreaded week I did power pumping which increased my supply significantly. I always did power pumping first thing in the morning (around 5am) when milk supply is at its height and would pump for 20 minutes, rest for 10 minutes, pump for 10 minutes, rest for 10 minutes, and finish with pumping for 10 minutes. I was instructed to do power pumping for no longer than a week; many moms are able to see a big difference in supply in a few days.

Tips for Supplementing and Maintaining Breastfeeding Relationship

After all my work, the doctors still pressured us to supplement with formula. The baby had lost 11% of her birth weight by the first week and they stressed us out until we gave in and supplemented with formula. There were techniques that helped us with this transition including using the Paced bottle-feeding method. In combination with the Como Tomo slow flow bottles our baby was able to take her time eating so when she returned to the breast she wasn’t too upset/fatigued by the slow flow at the breast.

Similarly, using the finish at the breast method helped to maintain our breastfeeding time. The method focuses on feeding the baby a supplement similar to an appetizer so that the baby isn’t overly hungry or upset when it’s time to breastfeed and there may be a slow let down or flow of milk.

I tried using the Supplemental Nursing System (SNS) to work on maintaining our latch and stimulate a let down. I was never able to master using the SNS, but know that it is a miracle worker for many moms. The Lact-Aid is a similar device that I was never able to try.

I hope this information is helpful to others as they use their resiliency and perseverance to create a breastfeeding relationship with their baby. I found that surrounding myself with supportive people, allowing myself space and time to grieve, and creating realistic short-term goals all helped me get through the process. I spent as much time as I could enjoying my baby. In retrospect I wish I would of spent less energy on feeling sad and angry about my supply and more time cuddling my tiny miracle. My thoughts and heart are with everyone dealing with this challenge.